Frequently Asked Questions

Obsessive-compulsive disorder (OCD) is an illness that causes people to have distressing, intrusive, irrational thoughts, images or impulses (i.e., obsessions) and to perform repetitive behavioral or mental acts (i.e., compulsions) aimed at reducing distress or preventing some dreaded situation. Read the DSM-5 Criteria for OCD.

Although everyone with OCD has obsessions and/or compulsions, the content varies from person to person. Typical obsessions include repetitive fears of causing harm or being harmed, fears of contamination and illness, fears of making mistakes, intrusive distressing sexual or religious imagery, or fears of losing things. Typical compulsions include repetitive washing and cleaning, excessive checking, excessive ordering, and arranging, or extreme hoarding and saving. Some people with OCD have only one type of obsession or compulsion; others have several types of obsessions and compulsions.

OCD occurs in 1-3 percent of the population with its onset typically occurring in adolescence or young adulthood (although it can start in childhood). The course is often chronic.

When obsessions and compulsions cause marked distress, are time-consuming (for example, take more than one hour a day), or interfere with functioning, treatment is recommended. Two treatments significantly reduce the symptoms of OCD: cognitive-behavioral therapy (CBT) using exposure and ritual prevention and pharmacotherapy with serotonin reuptake inhibitors (SRIs) clomipramine (Anafranil), fluoxetine (Prozac), fluvoxamine (Luvox), paroxetine (Paxil), sertraline (Zoloft), citalopram (Celexa), and escitalopram (Lexapro).

Obsessions

• Obsessions are persistent and recurrent thoughts, urges, impulses, or images that are inappropriate and intrusive. These thoughts can cause feelings of anxiety, distress, or disgust
• Obsessions are not just excessive worries about real-life problems
• The patient tries to suppress or ignore the obsessions or to neutralize them with a different thought or behavior
• The patient recognizes that the obsessions are not based on reality

Examples of Obsessions

• Fears of contamination or germs
• Fears of harming oneself or others
• Concerns about order and symmetry
• Unwanted sexual or religious thoughts

Compulsions 

• Compulsions are repetitive behaviors or mental acts that the patient feels driven to perform according to strict rules, or to bring down anxiety, or to prevent a feared event or situation
• The compulsions are clearly excessive or are not connected in a realistic way with what they are supposed to neutralize or prevent

Examples of Compulsions

• Excessive hand washing or cleaning
• Excessive checking (e.g., locks, doors, stoves, etc.)
• Ordering and arranging
• Counting, praying or repeating words silently to oneself

In adults, the lifetime prevalence of OCD is approximately 2.5%, and the 1-year prevalence is between 0.5%-2.1%. Research shows that the prevalence of OCD is similar in many different cultures around the world.

OCD most often begins in adolescence or early adulthood, but for many, it begins in childhood. OCD is typically a chronic disorder, with waxing and waning symptoms that can worsen due to stress.

The first-line treatments for OCD are medication with serotonin reuptake inhibitors (SRIs), therapy with Cognitive Behavioral Therapy (CBT), or their combination. Our center offers both types of treatment. We encourage patients to select the treatment that they feel most comfortable with.

• Serotonin Reuptake Inhibitors (SRIs): Serotonin reuptake inhibitors (SRIs) are the most effective pharmaceutical treatment for OCD. SRIs are antidepressants that block the re-absorption of serotonin in the brain. Although SRIs are commonly prescribed for depression, studies have found that they can be effective for patients with OCD. The doses required for treating OCD are often higher than the doses required for treating depression. Common side effects of SRIs include: nausea, diarrhea, sexual dysfunction, and headaches. Not all patients respond to SRIs and some who do still experience bothersome symptoms. For these patients, we recommend adding Cognitive-Behavioral Therapy (CBT).
• Cognitive-Behavioral Therapy (CBT): Cognitive-Behavioral Therapy (CBT) that includes Exposure and Ritual Prevention (or Exposure and Response Prevention; EX/RP, ERP) has been shown to be the most effective psychotherapy for OCD. The goal of CBT is to change dysfunctional thoughts, emotions, and behaviors. To do this, the therapist helps the patient repeatedly approach situations that trigger OCD-related anxiety or distress (exposure), while refraining from performing compulsions or rituals (ritual prevention). By doing this, the patient learns that their anxiety and distress will go down, and that feared consequences will not occur, even if they don’t do their rituals. CBT with EX/RP (ERP) is typically completed in 17-25 ninety-minute sessions.

Obsessive-compulsive personality disorder (OCPD) is a chronic maladaptive pattern of excessive perfectionism, preoccupation with orderliness and detail, and need for control over one's environment that leads to significant distress or impairment, particularly in areas of interpersonal functioning. Individuals with this disorder are often characterized as rigid and overly controlling. They may find it difficult to relax, feel obligated to plan out their activities to the minute and find unstructured time intolerable.

According to recent studies, about a quarter to a third of individuals with OCD meet criteria for OCPD. There is also evidence of a familial association between OCPD and OCD with studies showing increased frequencies of OCPD traits in the first degree relatives of individuals with OCD. Despite the apparent relationship between the disorders and some similarities in their symptoms, there are distinct differences between the conditions. OCD is characterized by intrusive and distressing obsessions; in contrast, OCPD traits and symptomatic behaviors are viewed by affected individuals as appropriate and correct, though they can lead to significant distress due to the associated need for control.

Individuals who participate in our research studies may be eligible to receive medication and/or therapy for OCD. This treatment is at no cost to you. For more information, visit our Participate in Research page or feel free to reach out to us directly.

We are a research clinic, so any treatment that we offer is provided through participation in our research and at no cost to you. We do not take insurance or accept payment for the treatment that we provide. For more information, visit our Participate in Research page or feel free to reach out to us directly.

The amount of time each study takes varies. Some studies only take a few hours, while others can last over the course of a few weeks. For more information, visit our Participate in Research page or feel free to reach out to us directly.

We do offer compensation for some of our research studies and the amount varies for each study. For more information, visit our Participate in Research page or feel free to reach out to us directly.

Yes, possibly. Our studies often include different groups of people who don't have OCD, such as the siblings of people with OCD and people who have anxiety disorders. For more information, visit our Participate in Research page or feel free to reach out to us directly.

Yes, any identifying information (ie. Name, address, birthdate, etc) that you provide is kept strictly confidential. Your information will not be shared outside of our center. For more information, visit our Participate in Research page or feel free to reach out to us directly.